Please complete all details in CAPITAL letters using black ink.Tick where necessary Account No (for office use only)

1 COMPANY DETAILS

Current Account Savings Account

ACCOUNT OPENING FORM CORPORATE

2 ANNUAL TURNOVER

N5 Billion - Above N4.99 Billion - N500 Million N499.9 Million - N50 Million N49.9 Million - Below

Is Your Company Quoted On The Stock Exchange? YES NO

COMPANIES, PARTNERSHIP & SOLE PROPRIETORSHIP

Type/Nature of Business

Opening Business Address

Corporate Business Address/Registered Office (If different from above)

Email Address

Certificate of Incorporation Number

Date of Incorporation D M Y

Company Name

Mobile No (1)

Mobile No (2)

Tax Identification Number (TIN)

CRM No/Borrwer’s Code

Website (if any)

ACCOUNT SERVICE(S) REQUIRED (PLEASE SPECIFY)3

Internet Banking Preferences

Internet Banking Mobile Banking SMS ALERT (Fee Applies)

Transaction Alert Preferences

Email Alert (Free)

Email

Statement Preferences

Post Monthly Quaterly Semi Quaterly

Frequency

Open Cheque

Cheque Book Requisition

50 Leaves 100 LeavesCrossed Cheque

Special Control Unit against Money laundering (SCUML) Reg. No:

You will be required to pre confirm any cheque above Nxxx,000.00. If you would like to have a higher threshold for pre-confirmation, please specify the amount (i.e. threshold above Nxxx,000.00)

N

CHEQUE CONFIRMATION THRESHOLD4

KEY CONTACT PERSONS/PRINCIPAL OFFICERS DETAILS5

(i)

(ii)

Mobile No

Job Title

Residential Address

Gender

FemaleMale

Date of BirthD M Y

Mother’s Maiden Name

Email

Means Of Identification

Occupation

First NameSurname Middle Name

ID Number BVN Number

Mobile No

Job Title

Residential Address

Gender

FemaleMale

Date of BirthD M Y

Mother’s Maiden Name

Email

Means Of Identification

Occupation

First NameSurname Middle Name

ID Number BVN Number

ACCOUNT SIGNATORY’S DETAILS6

(i)

DateD M Y

SignatureClass of Signatory(Please indicate class in the box provided)

Job Title

Residential Address

Gender

FemaleMale

Date of BirthD M Y

Mother’s Maiden Name

Mobile No Email

Means of IdentificationOccupation

First NameSurname Middle Name

ID Number

BVN Number

(ii)

DateD M Y

SignatureClass of Signatory(Please indicate class in the box provided)

Job Title

Residential Address

Gender

FemaleMale

Date of BirthD M Y

Mother’s Maiden Name

Mobile No Email

Means of IdentificationOccupation

First NameSurname Middle Name

ID Number

BVN Number

(iii)

DateD M Y

SignatureClass of Signatory(Please indicate class in the box provided)

Job Title

Residential Address

Gender

FemaleMale

Date of BirthD M Y

Mother’s Maiden Name

Mobile No Email

Means of IdentificationOccupation

First NameSurname Middle Name

ID Number

BVN Number

Nationality (for Non-Nigerian)

Residence Permit No.

Nationality (for Non-Nigerian)

Residence Permit No.

Nationality (for Non-Nigerian)

Residence Permit No.

DIRECTOR’S DETAILS7

(i)

DateD M Y

Signature

Means Of Identification

Job Title

Residential Address

Gender

FemaleMale

Date of BirthD M Y

Mother’s Maiden Name

ID Number

Mobile No

Email

Occupation

First NameSurname Middle Name

BVN Number

(ii)

DateD M Y

Signature

Means Of Identification

Job Title

Residential Address

Gender

FemaleMale

Date of BirthD M Y

Mother’s Maiden Name

ID Number

Mobile No

Email

Occupation

First NameSurname Middle Name

BVN Number

(iii)

DateD M Y

Signature

Means Of Identification

Job Title

Residential Address

Gender

FemaleMale

Date of BirthD M Y

Mother’s Maiden Name

ID Number

Mobile No

Email

Occupation

First NameSurname Middle Name

BVN Number

FOR SOLE PROPRIETORSHIP8

(i) Personal Information

(ii) Contact Details

Email Address

Street NameResidential No City/Town

Landmarks Mobile No (1)

Mobile No (2)

(iii)Means of Identification

Please specify ID type

National ID National Driver’s License

International Passport Other (Please Specify)

ID No ID Issue Date D M Y

ID Expiry Date D M Y

(iv)Details Of Next of Kin

Street Number

City/Town

Street Name

Landmarks

Relationship

Mobile No

Contacts Details

First NameSurname

Email Address

Middle Name

Nick Name

Nationality (For non Nigeria)

Residents Permit No

State of Origin

Tax Identification Number (TIN)

LGA

Title First Name

Middle Name

Gender

FemaleMale

Date of BirthD M Y

Surname

Marrital Status

Other (Please specifyMarriedSingle

Mother’s Maiden Name

BVN Number

ADDITIONAL DETAILS9

Name Of Affiliated Company/BodyI

1.

2.

3.

PRINCIPAL SHAREHOLDERS (Shareholding of 5% and above)II(a)

Mobile No

Email AddressStatus

Percentage Holding

First NameSurname Middle Name

(b)

Mobile No

Email AddressStatus

Percentage Holding

First NameSurname Middle Name

(c)

Details of Account Held With Other Banks By The Prospective Company/Partnership/Sole ProprietorshipIII

S/N NAME AND ADDRESS OF BANK/BRANCH

ACCOUNT NAME ACCOUNT NUMBER

DATE ACCOUNT OPENED

STATUS:ACTIVE/DORMANT

D M Y

D M Y

1.

2.

3.

4.

Mobile No

Email AddressStatus

Percentage Holding

First NameSurname Middle Name

IV Director Bank Account Details

S/N NAME AND ADDRESS OF BANK/BRANCH

ACCOUNT NAME ACCOUNT NUMBER

DATE ACCOUNT OPENED

STATUS:ACTIVE/DORMANT

D M Y

D M Y

1.

2.

3.

4.

ACCOUNT OPENING MANDATE10

Account No Name of Organization

(i)Signatories

Type of Account (Please Tick As Appropriate)

Current account Savings account

(ii)

(iii)

Identification Type

Identification Number

First NameSurname Middle Name

Signature ID Expiry DateD M Y

Identification Type

Identification Number

First NameSurname Middle Name

Signature ID Expiry DateD M Y

Identification Type

Identification Number

First NameSurname Middle Name

Signature ID Expiry DateD M Y

Identification Type

Identification Number

First NameSurname Middle Name

Signature ID Expiry DateD M Y

(iv)

NOTE: The institution can provide more space if the number of Signatories to the account is more than spaces (4) provided.

AUTHORITY TO DEBIT ACCOUNT FOR SEARCH FEE11

Prudential Mortgage Bank Limited

Dear Sir

Thank you.

We hereby authorize you to debit our account with the sum of N being the legal cost of search conducted on our account at the Corporate Affairs Commission.

LETTER OF SET-OFF12

Prudential Mortgage Bank Limited

I/We agree that you (in addition to any general lien or similar right to which you os my/our bonker may have at any time and without notice to me/us) combine or consolidate all or any of the company's accounts with all liabilities to you and set off or transfer any sum standing to the credit of any such accounts, be it cash, cheques, valuable, deposits, securities, negotiable instruments or other assets belonging to me/us with you in or towards satisfaction of any of my/our liabilities to you or any other account or in any other respect, whether such liabilities be actual or contingent, primary or collateral, several or joint.

Miss/Mr/Mrs/Chief

resolved:

e. To be bound by any notification of change in conditions governing that account directed to our last known address and any notices or later sent to our last address shall be considered as duly delivered and received by us at the time it would be delivered in the ordinary course of post.

f. That if a cheque credited to our account is returned dishonoured, the same may be transmitted to us through our last known address either by bearer or by post.

TO:

BANK LIMITED

I/We hereby request and authorize you

At a meeting of the Board of Directors of the Company held pursuant to this application

PRUDENTIAL MORTGAGE

a. To assume full responsibility for the genuineness or correctness and validity of all endorsements appearing on all cheques, orders, bills notes, validity of all instrument, receipts and for other documents deposited in respect of our account with the Bank.

2. To honour all cheques or other orders which may be drawn on the said account unless the Bank receives a written notice to the contrary; provided such withdrawal vouchers or other orders are signed by the authorized signatories to the account, and to debit such cheques or other orders to the said account be for the time being in credit or overdrawn or may become overdrawn in consequence of such debit without prejudice to your right to refuse to allow any draft or increase of overdraft and in consideration.

account in our/my name and subsequently to open further accounts as I/We may direct.

1. To open a Prudential........................................................

b. To further confirm all cheques, orders, bills, notes as specified in the cheques confirmation threshold in page one of this Form, to our assigned account officer or other designated Prudential Mortgage Bank staff. The Bank may not be bound to honour such instruments otherwise.

I/we agree:

c. To be responsible for the repayment of any overdraft with interest and to comply and be bound by the Bank's rules for the conduct of receipts of which We hereby acknowledge; and be bound by the Bank due to any future Government order, Law, Levy, Tax, embargo, moratorium, exchange restrictions and/or all other causes beyond the Bank's control.

d. That all funds standing to our credit are payable on demand only in such local currency as may be in circulation.

g. That our attention has been drawn to the necessity of safe guarding our withdrawal booklet so that unauthorized persons are unable to gain access to it and to the fact that neglect of this precaution may be a ground for any consequential loss being charged to our account.

h. That the Bank is under no obligation to honour our cheque(s) drawn on this account unless there are sufficient funds in the account to cover the value of the said withdrawal. I/We understand and agree that such cheque may be returned to us unpaid, but if paid I/we agree to pay the Bank on demand.

i. That any sum standing to the debit of the account shall be liable to interest charges at the rate fixed by the Bank from time to time. The Bank is authorized to debit the account the usual banking charges, interest, commissions and any service charge set by the management from time to time.

j. That the Bank will not accept liability whatsoever for funds handed to members of staff outside banking hours or outside the Bank's premises, unless by specific agreement in writing with the Bank.

4. I/We also agree that in addition to any general lien or similar rights to which you as bankers may be entitled by law you may at any time and without notices to us combine or consolidate all or any of my/our account in New Prudential with any liabilities to you and set or transfer any sum or sums standing to the due credit of anyone more of such accounts or any other credit, be it cash, cheque, valuables, deposit, securities, negotiable instruments or other account or in any other respect whether such liabilities be actual or contingent collateral and several or joint.

3. I/We also agree that the Bank may debit our account for charges or fees arising from legal documentation to regularize our account on complete opening formalities.

k. That any disagreement with entries on our Bank statement will be made known by us within fifteen days of forwarding the Bank statement via electronic mail. Failing receipt by the Bank of a notice of disagreement of the within fifteen days from the date of forwarding of our Bank statement, it will be deemed by the Bank that the statement as rendered is correct.

TERMS AND CONDITIONS

MANDATE & RESOLUTION

I/We hereby apply for the opening of any account or accounts with Prudential Mortgage Bank Limited. I/We understand that the information given herein is the basis for opening such account(s) and herebywarrant that such information is correct.

I/We agree to use the account for only transaction permitted by law and to be bound by the terms and conditions.

Authorized Signature of the Customers/Representative & Date

Authorized Signature of the Customers/Representative & Date

Authorized Signature of the Customers/Representative & Date

Authorized Signature of the Customers/Representative & Date

SIGNED, SEALED & DELIVERED BY THE WITHIN NAMED PERSON15

IN THE PRESENCE OF16

Name

Address

Occupation Signature

DateD M Y

Name Signature

Status

Name Signature

Status Company Seal Here

REQUIREMENTS CHECKLIST17

S/N DOCUMENTS REQUIRED CHECKED DEFERRED WAIVED N/A

1. Account opening form duly completed

2. Specimen signature card duly completed

3. Copy of certificate of incorporation

4. Board Resolution

5.(Certified as true copy by the Registrar of Company)Copy of Memorandum and Article of Association

6. (a) Form C07 Particulars of Directors

7. (b) Form CO2 Allotment of Shares

8. Partnership Deed

9. Approval Letter (for Government Agency)

10. Gazette (for Government Agency)

11. Two (2) passport sized photographs at each signatory to the account with name written on the reverse side

12. Introduction letter with two (2) passport sized Photographs at contact persons or authorized agent

13. Status report from Banker (where applicable)

DateD M Y

DateD M Y

Name Signature

Status DateD M Y

14. Resident Permit (for non-Nigerians)

15. Evidence of Registration with NIPC

16. Search Report

17. Power of Attorney

18. Letter of Indemnity

19. Proof of Company address

20. Business Premises visitation certificate

21. Proof of Identity of all Signatories and Directors

22. Proof of address of all signatories and Directors: Utility bill, (Certified true copy is acceptable if original is not held)

23. Reference forms

24. Other (please specify)

FOR BANK USE ONLY

ACCOUNT OPENED BY:A

Name

Signature

COMMENT(S)

DateD M Y

DEFERRAL OF DOCUMENT IF ANY AUTHORISED BY: B

Name

Signature DateD M Y

ADDRESS VERIFICATION CARRIED OUT BY:C

Name

Signature DateD M Y

ACCOUNT OPENING APPROVED BY:D

Name

Signature DateD M Y